Wernicke's encephalopathy in hyperemesis gravidarum: A systematic review
Oudman E, et al.
Published in European Journal of Obstetrics & Gynecology and Reproductive Biology
Methodology
Systematic review of published case reports and series of Wernicke's encephalopathy occurring in hyperemesis gravidarum, extracting presentation, precipitating factors, treatment and maternal and fetal outcomes.
Key Findings
Systematic review of 177 cases of Wernicke's encephalopathy complicating hyperemesis gravidarum found the classic triad was often incomplete, symptoms typically appeared after several weeks of vomiting, intravenous glucose without prior thiamine frequently precipitated onset, and outcomes included high rates of persistent memory impairment and fetal loss despite thiamine treatment.
Conclusions
Thiamine must be given before glucose in prolonged pregnancy vomiting: Wernicke's encephalopathy in hyperemesis gravidarum is preventable but causes lasting neurological damage and fetal loss when missed.
Limitations
Case-report and case-series evidence only, subject to publication bias toward severe or unusual presentations; inconsistent reporting of thiamine dose, timing and follow-up; no controlled comparison of prophylactic regimens.
Supplements Studied
To eradicate WE in pregnancy, it is necessary to give 100 mg of intravenous or intramuscular thiamine in HG patients with persistent or severe late onset vomiting to prevent them from developing WE.
Related Health Concerns
Study Details
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Disclosures
Funding
Academic institutional funding
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